Supervisor Assessment Research Articles

General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients - is cultural competence adequately considered?

BackgroundGeneral Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care.MethodsA simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision.ResultsSixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified.ConclusionsThe role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the disadvantage faced by vulnerable populations.

Reflection on the education for clinical postgraduates with professional degree majoring in ;general practice

General practice is a clinical practice which integrates a variety of disciplines and aims at providing basic health care services for individuals, families and communities. General prac-tice in China is now experiencing increasing development. In 2011, the Academic Degrees Committee of the State Council approved of the addition of general practice under the category of clinical medicine, initiating the education of postgraduates with professional degree majoring in general prac-tice. Through analyzing supervisor instruction, curriculum, skill training and assessment of postgrad-uates majoring in general practice, this paper thoroughly explored its training mode. Key words: Postgraduates majoring in general practice; Postgraduate education; Profes-sional degree

Factors Contributing to Driving Safety in the Trucking Industry

OCCUPATIONAL APPLICATIONS This study sought to identify factors contributing to preventable road traffic crashes, based on analyses of crash records collected from 18 trucking companies in Japan. Road crashes in the trucking industry were found to be associated with the following factors: penalty points of the driver's license, emotional stability, safety attitudes, delivery area or range, driver workload, and driving experience. In addition to well-known causal factors for driver errors in road transport, these results suggest that managers in a trucking firm should provide drivers with safety-oriented work schedules to control stress and workload. Examples include more frequent breaks (for a shorter duration), particularly for medium- or long-distance drivers, controlling annual driving distance, and training not only for technical skills but also for enhanced safety attitudes and behaviors. TECHNICAL ABSTRACT Background: Occupational traffic safety is recognized as one of the most crucial social issues to address in many countries. Yet, causal factors for road crashes involving occupational drivers have not been fully investigated. Purpose: This study sought to identify important factors contributing to safety outcomes of occupational truck drivers in Japan. Methods: A total of 1292 drivers’ road crash and work-related records were collected from 18 trucking companies in Japan. Each record specified individual and task-related attributes and history of road crashes from 2004 to 2006. As individual attributes, each record included age, gender, experience, employment condition, supervisor assessment of fuel-efficient driving, penalty points on driver's license, scores of five personality and attitude factors, and four sensorimotor functions measured by a driver aptitude test. Examples of task-related attributes were vehicle type, delivery, and annual working days. Chi-square tests were used to examine differences between “crash-free” and “crash-involved” drivers for potential contributing factors. Results: Several driver factors contributing to safety performance were identified. For instance, years of occupational driving experience were positively associated with higher levels of traffic safety. Drivers with fewer driver's license penalty points were less likely to have been involved in a road crash. Results also suggested that drivers’ emotional stability and positive safety attitudes are associated with lower involvement in road crashes. In addition to these individual attributes, some task-related factors were identified that may influence the likelihood of crash involvement (e.g., delivery range and annual driving distance). Conclusions: Several driver factors, such as fewer driver's license penalty points, high emotional stability, positive safety attitudes, and reasonable workload, were associated with mitigation of crash risk. This suggests that occupational truck drivers should be provided safety-oriented work schedules and conditions for appropriately controlling workload and training not only for technical skills but also for safety-related attitudes and behaviors.

Nuts and bolts of entrustable professional activities.

The entrustable professional activity (EPA) concept allows faculty to make competency-based decisions on the level of supervision required by trainees. Competency-based education targets standardized levels of proficiency to guarantee that all learners have a sufficient level of proficiency at the completion of training.1–6 Collectively, the competencies (ACGME or CanMEDS) constitute a framework that describes the qualities of professionals. Such a framework provides generalized descriptions to guide learners, their supervisors, and institutions in teaching and assessment. However, these frameworks must translate to the world of medical practice. EPAs were conceived to facilitate this translation, addressing the concern that competency frameworks would otherwise be too theoretical to be useful for training and assessment in daily practice.Trust is a central concept for safe and effective health care. Patients must trust their physicians, and health care providers must trust each other in a highly interdependent health care system. In teaching settings, supervisors decide when and for what tasks they entrust trainees to assume clinical responsibilities. Building on this concept, EPAs are units of professional practice, defined as tasks or responsibilities to be entrusted to the unsupervised execution by a trainee once he or she has attained sufficient specific competence. EPAs are independently executable, observable, and measurable in their process and outcome, and therefore, suitable for entrustment decisions. Sequencing EPAs of increasing difficulty, risk, or sophistication can serve as a backbone for graduate medical education.6An EPA must be described at a sufficient level of detail to set trainee expectations and guide supervisor's assessment and entrustment decisions (see table 2 for guidelines).Milestones, as defined by the ACGME, are stages in the development of specific competencies. Milestones may link to a supervisor's EPA decisions (eg, direct proactive supervision versus distant supervision). The Pediatrics Milestone Project provides examples of how milestones can be linked to entrustment decisions.7,8Entrustment decisions involve clinical skills and abilities as well as more general facets of competence, such as understanding one's own limitations and knowing when to ask for help. Making entrustment decisions for unsupervised practice requires observed proficiency, usually on multiple occasions.In practice, entrustment decisions are affected by 4 groups of variables: (1) attributes of the trainee (tired, confident, level of training); (2) attributes of the supervisors (eg, lenient or strict); (3) context (eg, time of the day, facilities available); and (4) the nature of the EPA (rare, complex versus common, easy). Entrustment decisions can be further distinguished as ad hoc (eg, happening during a night shift) or structural (establishing the recognition that a trainee may do this activity at a specific level of supervision from now on). In the clinical context, many ad hoc entrustment decisions happen every day. Structural entrustment decisions formally acknowledge that a trainee has passed a threshold that allows for decreased supervision. The certificate awarded at such occasions has been called a statement of awarded responsibility (STAR) and should be carefully documented.2Linking an EPA with a competency framework emphasizes essential competency domains when observing a trainee executing the EPA.Decide how many EPAs are useful for training.While there can be many EPAs that serve to make ad hoc entrustment decisions, EPAs that lead to structural entrustment decisions (ie, certification or STARs) should involve broad-based responsibilities and be limited in number. For a graduate medical education program, no more than 20 to 30 EPAs are recommended.EPAs can be the focus of assessment. The key question is: Can we trust this trainee to execute this EPA? The answer may be translated to 5 levels of supervision for the EPA:

部下に対する上司のポジティブ・フィードバックが機能しないとき

This experimental study investigated how leader-member exchange (LMX) and positive feedback pertinent to the goal is related to subordinates' responsibility, assessment of their supervisors, and feeling of being implicitly scolded, to elaborate and confirm the findings of Bezuijen et al. (2010). We hypothesized that positive feedback pertinent to the goal would be more effective compared to unrelated feedback. Secondly, we hypothesized that this effect would be moderated by the quality of LMX. Undergraduate students (29 male, 51 female; 20.4 +/- .63 yrs) participated as subordinates in an experiment consisting of two sessions. The results supported our hypotheses. We found that the positive feedback pertinent to the goal led to increased levels of responsibility. This effect was greater under high-quality LMX conditions, but was inhibited under low-quality LMX conditions. In the high-quality LMX condition, subordinates who did not get any feedback decreased their responsibility, gave lower supervisor assessment ratings, and felt more strongly scolded than under conditions where they received feedback. We discussed the importance of the combination of the quality of the relationship and positive feedback related to the goal, and provided directions for future research.

A critical evaluation of the validity and the reliability of global competency constructs for supervisor assessment of junior medical trainees

Supervisor assessments are critical for both formative and summative assessment in the workplace. Supervisor ratings remain an important source of such assessment in many educational jurisdictions even though there is ambiguity about their validity and reliability. The aims of this evaluation is to explore the: (1) construct validity of ward-based supervisor competency assessments; (2) reliability of supervisors for observing any overarching domain constructs identified (factors); (3) stability of factors across subgroups of contexts, supervisors and trainees; and (4) position of the observations compared to the established literature. Evaluated assessments were all those used to judge intern (trainee) suitability to become an unconditionally registered medical practitioner in the Australian Capital Territory, Australia in 2007-2008. Initial construct identification is by traditional exploratory factor analysis (EFA) using Principal component analysis with Varimax rotation. Factor stability is explored by EFA of subgroups by different contexts such as hospital type, and different types of supervisors and trainees. The unit of analysis is each assessment, and includes all available assessments without aggregation of any scores to obtain the factors. Reliability of identified constructs is by variance components analysis of the summed trainee scores for each factor and the number of assessments needed to provide an acceptably reliable assessment using the construct, the reliability unit of analysis being the score for each factor for every assessment. For the 374 assessments from 74 trainees and 73 supervisors, the EFA resulted in 3 factors identified from the scree plot, accounting for only 68 % of the variance with factor 1 having features of a "general professional job performance" competency (eigenvalue 7.630; variance 54.5 %); factor 2 "clinical skills" (eigenvalue 1.036; variance 7.4 %); and factor 3 "professional and personal" competency (eigenvalue 0.867; variance 6.2 %). The percent trainee score variance for the summed competency item scores for factors 1, 2 and 3 were 40.4, 27.4 and 22.9 % respectively. The number of assessments needed to give a reliability coefficient of 0.80 was 6, 11 and 13 respectively. The factor structure remained stable for subgroups of female trainees, Australian graduate trainees, the central hospital, surgeons, staff specialist, visiting medical officers and the separation into single years. Physicians as supervisors, male trainees, and male supervisors all had a different grouping of items within 3 factors which all had competency items that collapsed into the predefined "face value" constructs of competence. These observations add new insights compared to the established literature. For the setting, most supervisors appear to be assessing a dominant construct domain which is similar to a general professional job performance competency. This global construct consists of individual competency items that supervisors spontaneously align and has acceptable assessment reliability. However, factor structure instability between different populations of supervisors and trainees means that subpopulations of trainees may be assessed differently and that some subpopulations of supervisors are assessing the same trainees with different constructs than other supervisors. The lack of competency criterion standardisation of supervisors' assessments brings into question the validity of this assessment method as currently used.

Implementing a Work-Based Learning Approach to 4-H Camp Counseling

Although camping has been a successful 4-H delivery method, we believed a more intentional approach that viewed camp counseling as a job would allow teen camp counselors to connect skills they were learning with those needed for workforce success. Eighteen Ohio counties participated in a pilot project to test the implementation of this work-based learning approach. 4-H youth development professionals added specific workforce-related topics and made minor changes in their camp counselor training. In addition, they used a performance appraisal process consisting of teens’ self-assessment and supervisor assessment. Focus groups were conducted to gain implementation data. Although there were some challenges, this approach took relatively little additional effort, and there were benefits for both counselors and professionals. This intentional approach could be applied to other youth programs.

Projected Federal Government Computer Personnel Needs: Results Of An Oklahoma Survey

The purpose of this paper is to report the results of a study made to determine the projected performance requirements and skills (training needed) by personnel entering governmental information processing jobs during the next several years as viewed by supervisors in governmental agencies. The specific problems addressed are as follows:1. The identification of the performance requirements for computer programmers and systems analysts which government employers expect to be needed for employment in the field of information processing during the last have of the 1980s;2. The effectiveness of currently employed computer programmers and systems analysis as determined by supervisor assessment;3. Identification of the areas in which colleges and universities will need to make curricular changes in order to provide the government as well as the business community with properly trained professionals in information processing.

A review of prevocational medical trainee assessment in New South Wales

To evaluate the effectiveness of formal assessments of prevocational medical trainees (ie, interns, first-year residents and international medical graduates undergoing supervised training). Retrospective review of structured assessment forms that are completed by all prevocational trainees and their supervisors in New South Wales public hospitals. We reviewed the first 3390assessment forms, representing assessments of 1072trainees at 43training sites (83% of all prevocational trainees in NSW) since January 2009. (i) Trainee ratings on 19assessment items by self-assessment and by supervisor assessment; and (ii) quantity and quality of written comments provided in assessments. At the end of term, 43% of trainees assessed themselves as performing "at expected level" on all 19rating items. Nearly 99% of trainees were assessed by their supervisors as performing at or above the expected level on all assessment items. Written comments by supervisors were generally short and encouraging, but lacked specific feedback that trainees might use to guide improvements in performance. As currently used by trainees and supervisors, the assessment forms may underreport trainee underperformance, do not discriminate strongly between different levels of performance of trainees or the training system, and do not provide trainees with enough specific feedback to guide their professional development.

Supervisor assessment of clinical and professional competence of medical trainees: a reliability study using workplace data and a focused analytical literature review

Even though rater-based judgements of clinical competence are widely used, they are context sensitive and vary between individuals and institutions. To deal adequately with rater-judgement unreliability, evaluating the reliability of workplace rater-based assessments in the local context is essential. Using such an approach, the primary intention of this study was to identify the trainee score variation around supervisor ratings, identify sampling number needs of workplace assessments for certification of competence and position the findings within the known literature. This reliability study of workplace-based supervisors' assessments of trainees has a rater-nested-within-trainee design. Score variation attributable to the trainee for each competency item assessed (variance component) were estimated by the minimum-norm quadratic unbiased estimator. Score variance was used to estimate the number needed for a reliability value of 0.80. The trainee score variance for each of 14 competency items varied between 2.3% for emergency skills to 35.6% for communication skills, with an average for all competency items of 20.3%; the "Overall rating" competency item trainee variance was 28.8%. These variance components translated into 169, 7, 17 and 28 assessments needed for a reliability of 0.80, respectively. Most variation in assessment scores was due to measurement error, ranging from 97.7% for emergency skills to 63.4% for communication skills. Similar results have been demonstrated in previously published studies. In summary, overall supervisors' workplace based assessments have poor reliability and are not suitable for use in certification processes in their current form. The marked variation in the supervisors' reliability in assessing different competencies indicates that supervisors may be able to assess some with acceptable reproducibility; in this case communication and possibly overall competence. However, any continued use of this format for assessment of trainee competencies necessitates the identification of what supervisors in different institutions can reliably assess rather than continuing to impose false expectations from unreliable assessments.

An evaluation of clinical dietetic student placement case‐mix exposure, service delivery and supervisory burden

AbstractAim: To evaluate the attributes of clinical dietetics student placement exposure to patient case‐mix and supervision, types of services delivered and to estimate and compare costs and benefits of student activity and supervision while on placement.Methods: Descriptive study of three annual cohorts of student dietitians (n = 59) collecting data prospectively over a continuous 10‐week clinical placement period. Data focused on student case‐mix exposures and student and supervisor verified time utilisation. Descriptive analysis of data relating to student case‐mix exposure, student service delivery and direct supervisory practices was performed to explore the attributes of student placement experiences. Student and supervisor time utilisation data were used to model estimates of dollar costs and benefits based on occasion of service as a measure of clinical productivity.Results: Data collected indicate that student service delivery activity increases and direct supervision decreases significantly as time on placement increases. The minimum occasion of service exposure required to achieve supervisor assessment of entry‐level competency was 47 occasion of service (mean 165.8 occasion of service) and the maximum 306 occasion of service. Over one‐third of all occasion of service provided by students was not directly supervised. Cost–benefit estimates indicate that a student needs to be over 80% as time efficient throughout the placement as a new graduate to offset the costs of direct student supervision.Conclusion: These data highlight the variability of student clinical placement experiences and exposure to learning opportunities and support evidence‐based dialogue about resource exchange to support student placements.

Agreement between Task-Based Estimates of the Full-Shift Noise Exposure and the Full-Shift Noise Dosimetry

Noise assessments have been conducted using full-shift dosimetry and short-term task-based measurements. Advantages of the task-based method include the opportunity to directly identify high-noise exposure tasks and to target control measures, as well as obtain estimates of task-based full-shift exposures; however, there is little empirical evidence comparing the two methods. National Institute for Occupational Safety and Health assessed noise exposures at three industrial facilities using dosimetry and task-based methods with the objective of comparing the two strategies and assessing the degree of agreement and causes of disagreement. Eight indices of task-based full-shift exposures were created from task-based sampling using three methods to assess time-at-task (direct observation by industrial hygienist, end-of-shift worker estimates and supervisor estimates) and three methods to assign noise levels to tasks [direct measurement, arithmetic mean (AM) and geometric mean (GM)]. We assessed aspects of agreement (precision, bias and absolute agreement) using Bland-Altman plots and concordance correlation coefficient (CCC). Overall, the task-based methods worked fairly well, with mean biases less than +/-2.8 dBA and precision ranges of 3.3-4.4 dBA. By all measures, task-based full-shift estimates based on supervisor assessment of time-at-task agreed most poorly with the dosimetry data. The task-based full-shift estimates based on worker estimates of time-at-task generally agreed as well as those based on direct observation. For task noise level, task-based full-shift estimates based on directly measured task agreed the best with dosimetry data, while agreement for task-based indices based on task AM or GM was variable. Overall, the task-based full-shift estimates based on direct observation task and direct measured task noise level achieved the best agreement with the dosimetry data (CCC 0.84) with 95% of their differences being within 7.4 dBA and 56% of the differences <3 dBA. For this index, a high degree of accuracy was observed (accuracy coefficient = 0.96) with major cause of disagreement arising from a lack of precision (precision coefficient = 0.88). When the measurements were classified by job characteristics, significant improvements in the degree of agreement were observed in the low job mobility, low job complexity and low job variability categories. Our data suggest that a high degree of absolute agreement can be achieved between the task-based and dosimetry-based estimates of full-shift exposures. The task-based approach that uses worker reports combined with task AM or GM levels is similar to the more time-intensive direct observation method to estimate full-shift exposures.

The Supervision Dance: Learning to Lead and Follow a Student Teacher

This article chronicles the journey of a student teaching supervisor as she worked with one of her student teachers. Early in their relationship, the supervisor's assessment of the student teacher's dispositions for teaching triggered concern. In this self-study, the supervisor was guided by Nel Noddings' (2003) phenomenological description of ethical care as she tried to engage the student teacher in dialogue about his growth as a beginning educator. The supervisor intended to include the student teacher's goals along with her assessments to support his professional development. Exchanging the lead in the supervision dance warranted ethical considerations. The supervisor, working within the limited timeframe of the student teaching experience, had the dual responsibilities of coaching and assessing the student teacher's performance as he worked toward licensure. She also had to manage her limited time for attending to the needs of the student teacher. The repercussions included the supervisor taking center stage more than she had originally planned and adapting her schedule to better explore the student teacher's motivations and aspirations.

The Value of Common Perspectives in Self-Reported Appraisals

This article uses the work of Smircich and Chesser on direct and meta-perspectives (i.e., points of view) to test the correspondence between self-reported and supervisory ratings of performance. Results from two field studies indicate a higher level of self-supervisor rating correlation when using a common perspective. Similar results were obtained using an alternative measure of rating correspondence. The results provide evidence that researchers using self-reports of performance as surrogates for archival performance data should ask respondents for their supervisor's assessment of their performance rather than for their own assessment. The practical implications of these results for field research are discussed.

Leniency and halo effects in marking undergraduate short research projects

BackgroundSupervisors are often involved in the assessment of projects they have supervised themselves. Previous research suggests that detailed marking sheets may alleviate leniency and halo effects. We set out to determine if, despite using such a marking schedule, leniency and halo effects were evident in the supervisors' marking of undergraduate short research projects (special study modules (SSM)).MethodsReview of grades awarded by supervisors, second markers and control markers to the written reports of 4th year medical students who had participated in an SSM during two full academic years (n = 399). Paired t-tests were used to compare mean marks, Pearson correlation to look at agreement between marks and multiple linear regression to test the prediction of one mark from several others adjusted for one another.ResultsThere was a highly significant difference of approximately half a grade between supervisors and second markers with supervisors marking higher. (t = 3.12, p < 0.01, difference in grade score = 0.42, 95% CI for mean difference 0.18–0.80). There was a high correlation between the two marks awarded for performance of the project and the written report by the supervisor (r = 0.75), but a low-modest correlation between supervisor and second marker (r = 0.28). Linear regression analysis of the influence of the supervisors' mark for performance on their mark for the report gave a non-significant result. This suggests a leniency effect but no halo effect.ConclusionsThis study shows that with the use of structured marking sheet for assessment of undergraduate medical students, supervisors marks are not associated with a halo effect, but leniency does occur. As supervisor assessment is becoming more common in both under graduate and postgraduate teaching new ways to improve objectivity in marking and to address the leniency of supervisors should be sought.

A ‘Fair Play’? Comparison of an Objective Structured Clinical Examination of Final Year Medical Students Training in Psychiatry and their Supervisors' Appraisals

Objective: Expected standards for student performance in psychiatry can vary between supervisors and institutions. Recently, the University of Auckland required its academic departments to have an objective standard assessment or test for each student on a clinical attachment. We aimed to compare an objective structured clinical examination of final year medical students training in psychiatry and their supervisors' appraisals. Method: Assessment in psychiatry initially consisted of a two-hour written test. Subsequently, the test in psychiatry changed to a standardised, modified, objective, structured, clinical examination (OSCE) using simulated patients. The clinical supervisor rated each student on a set of clinical parameters using a scale of 1-6. In addition, members of the academic department of psychiatry separately tested the students with a modified OSCE on the last day of their clinical attachment. The results of the OSCE are compared with clinical attachment assessments and the previous method of evaluation, the written test. Results: There was no correlation between the written test and the supervisor's assessment for the clinical attachment indicating that the written test was not a good method of evaluating student performance. The correlation between the clinical attachment grading and the OSCE for year 1 was 0.4 (p=0.002) and for year 2 was 0.5 (p=0.001). However, marks for the OSCE were consistently lower than those given for the clinical attachment. Conclusions: The introduction of the modified OSCE had the desired outcome of changing students' focus from the pursuit of theoretical knowledge to the attainment of practical skills.

Performance Rating Accuracy: Convergence Between Supervisor Assessment and Sales Productivity

The role of seven variables in predicting supervisor rating accuracy was examined. The study was conducted in natural settings, and the criterion for rating accuracy was the rated salesperson’s productivity in terms of sales. The predictors examined were the supervisor’s gender, the amount of time the supervisor spent working with the subordinate, the length of the supervisor–subordinate relationship, depth of acquaintance, the subordinate’s sensitivity to expressive behavior in others, the ability to modify self‐presentation and the subordinate’s age. The participants were 208 supervisors and 268 female salespersons. The results of a discriminant analysis showed that the variables predicting accuracy–inaccuracy were different from those predicting overestimation–underestimation. Accuracy was best predicted by the length of the supervisor–subordinate relationship and by the supervisor’s female gender. The direction of the inaccurate ratings was best predicted by high acquaintance, which pulled the ratings in a positively‐biased direction.

Correspondence of supervisor and subordinate perspectives during major organizational change.

Staff members (N = 2,605) and supervisors (N = 55) of 39 administrative units in 2 healthcare organizations completed a survey measuring confidence in the organization, engagement with their work, and occupational hazards. A correlational analysis determined correspondence between the perspectives of supervisors with those of staff reporting to them as their facilities adjusted to major organizational changes. Supervisors' scores were significantly and positively correlated with the corresponding scores of staff members on cynicism, meaningfulness, acceptance of change, goals, hospital reputation, and health risks. Regression analysis found that relationships were relatively domain specific: Supervisor engagement with work was positively related to that of their staff members, and supervisors evaluations of the organization were positively related to those of their staff members. Supervisor assessment of occupational hazards was related to all 3 areas of staff perception.

Correspondence of supervisor and subordinate perspectives during major organizational change.

Staff members (N = 2,605) and supervisors (N = 55) of 39 administrative units in 2 healthcare organizations completed a survey measuring confidence in the organization, engagement with their work, and occupational hazards. A correlational analysis determined correspondence between the perspectives of supervisors with those of staff reporting to them as their facilities adjusted to major organizational changes. Supervisors' scores were significantly and positively correlated with the corresponding scores of staff members on cynicism, meaningfulness, acceptance of change, goals, hospital reputation, and health risks. Regression analysis found that relationships were relatively domain specific: Supervisor engagement with work was positively related to that of their staff members, and supervisors evaluations of the organization were positively related to those of their staff members. Supervisor assessment of occupational hazards was related to all 3 areas of staff perception.

Responding to graduate students' professional deficiencies: A national survey

Seventy-one doctoral programs in professional psychology were surveyed with respect to the incidence of students' professional deficiencies and related procedures. Professional deficiencies, particularly limited clinical skills and personality/emotional problems, were reported by 89% of the respondents, twice the number that have official policies for dealing with such problems. Incidence of limited clinical skills was related positively to interviewing applicants and use of practicum grades for evaluation and related negatively to using recommendation letters and reliance on clinical supervisor's assessment. Responses to deficiencies reflected appropriate due process concepts and were most likely to include terminating students and psychotherapy referral. Recommendations are made for definitions of professional competencies, development of policies, and research on the reliability and validity of screening and evaluation mechanisms.